electrolytes
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Questions and Answers

What is the primary function of sodium in the body?

  • Maintenance of ECF concentration and volume (correct)
  • Regulation of blood pressure
  • Production of hormones
  • Transmission of nerve impulses

    • What is the primary determinant of osmolality in the body?

  • Magnesium levels
  • Calcium levels
  • Potassium levels
  • Sodium levels (correct)

    • What is the result of hypernatremia on the body's cells?

  • No change in cell water content
  • Cells become hypotonic
  • Water shifts into cells
  • Water shifts out of cells (correct)

    • What is the primary protection against hypernatremia?

    <p>Thirst</p> Signup and view all the answers

    What is the treatment for hypernatremia?

    <p>Hypotonic IV fluids</p> Signup and view all the answers

    What is the result of hyponatremia on the body's cells?

    <p>Water shifts into cells</p> Signup and view all the answers

    What is the treatment for hyponatremia caused by water excess?

    <p>Fluid restriction</p> Signup and view all the answers

    What is the treatment for severe hyponatremia symptoms?

    <p>Intravenous hypertonic saline solution</p> Signup and view all the answers

    What is the approximate percentage of body weight that is composed of intracellular fluid?

    <p>42%</p> Signup and view all the answers

    Which of the following ions is most prevalent in the interstitial fluid?

    <p>Na+</p> Signup and view all the answers

    What is the primary mechanism by which water moves from an area of high concentration to an area of low concentration?

    <p>Diffusion</p> Signup and view all the answers

    What is the term for the movement of water into a cell due to a higher concentration of solutes outside the cell?

    <p>Hypertonic solution</p> Signup and view all the answers

    What is the term for the movement of water out of a cell due to a higher concentration of solutes inside the cell?

    <p>Hypotonic solution</p> Signup and view all the answers

    What is the term for the movement of water into a cell due to an equal concentration of solutes inside and outside the cell?

    <p>Isotonic solution</p> Signup and view all the answers

    What is the primary mechanism by which sodium is kept out of the cell and potassium is kept in the cell?

    <p>Active transport</p> Signup and view all the answers

    What is the term for the osmotic pressure exerted by colloids in a solution?

    <p>Oncotic pressure</p> Signup and view all the answers

    What is the result of fluid shifting from the plasma to the interstitial space?

    <p>Edema</p> Signup and view all the answers

    Which of the following is a cause of fluid shifting from the plasma to the interstitial space?

    <p>Elevated venous hydrostatic pressure</p> Signup and view all the answers

    What is the primary cause of hypoproteinemia?

    <p>Anorexia and malnutrition</p> Signup and view all the answers

    Which of the following is a sign of hyperkalemia?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What is the primary treatment for hypovolemia?

    <p>Fluid replacement with normal saline</p> Signup and view all the answers

    Which of the following is a nursing diagnosis for hypervolemia?

    <p>Excess fluid volume</p> Signup and view all the answers

    What is the purpose of daily weights in patients with fluid imbalances?

    <p>To monitor fluid status (1 kg = 1000 ml)</p> Signup and view all the answers

    Which of the following electrolyte imbalances is associated with muscle twitching?

    <p>Hypocalcemia</p> Signup and view all the answers

    What is the primary cause of hypervolemia?

    <p>Excessive intake of fluids</p> Signup and view all the answers

    Which of the following is a clinical manifestation of hypoproteinemia?

    <p>All of the above</p> Signup and view all the answers

    What is the primary treatment for hypervolemia?

    <p>Remove excess fluid with diuretics or dialysis</p> Signup and view all the answers

    Which of the following is a sign of hyponatremia?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Fluid Compartments

    • There are three main fluid compartments: intracellular fluid (ICF), extracellular fluid (ECF), and transcellular fluid.
    • Intracellular fluid (ICF) is the fluid within cells, making up 42% of body weight and 2/3 of body water.
    • Extracellular fluid (ECF) is the fluid outside cells, divided into intravascular (plasma) and interstitial fluid (between cells, including lymph).
    • Transcellular fluid is a small but important fluid compartment, making up approximately 1 liter.

    Intracellular Fluid (ICF)

    • ICF is the fluid within cells, making up 42% of body weight and 2/3 of body water.
    • Potassium (K+) is the most prevalent intracellular cation.
    • Phosphate (PO4-) is the most prevalent intracellular anion.

    Extracellular Fluid (ECF)

    • ECF is the fluid outside cells, divided into intravascular (plasma) and interstitial fluid (between cells, including lymph).
    • Chloride (Cl-) is the most prevalent anion in interstitial fluid.
    • Sodium (Na+) is the most prevalent cation in interstitial fluid.
    • 2/3 of ECF is in interstitial fluid, and 1/3 is intravascular.

    Transcellular Fluid

    • Transcellular fluid is a small but important fluid compartment, making up approximately 1 liter.
    • It includes cerebrospinal fluid (CSF), gastrointestinal (GI) tract fluid, pleural space fluid, synovial spaces, and peritoneal space fluid.

    Mechanisms Controlling Fluid and Electrolyte Movement

    • Diffusion: the movement of molecules from an area of high concentration to an area of low concentration.
    • Facilitated diffusion: the movement of molecules with the help of carrier molecules.
    • Active transport: the movement of molecules against their concentration gradient, requiring energy (e.g., keeping sodium out and potassium in cells, using ATP).

    Osmosis and Hydrostatic Pressure

    • Osmosis: the movement of water between compartments separated by a membrane, from an area of high water concentration to an area of low water concentration.
    • Hydrostatic pressure: the force within a fluid compartment.
    • Oncotic pressure (colloid osmotic pressure): the osmotic pressure exerted by colloids (e.g., proteins) in a solution, pulling fluid into the vascular space.

    Fluid Shifts and Edema

    • Fluid shifts can occur from plasma to interstitial space, resulting in edema.
    • Causes of fluid shifts include elevated venous hydrostatic pressure, decreased plasma oncotic pressure, and elevated interstitial oncotic pressure.

    Electrolyte Disorders

    • Electrolyte imbalances can occur due to excess or deficit of sodium, potassium, calcium, and magnesium.
    • Signs and symptoms of electrolyte disorders vary depending on the specific electrolyte and whether it is in excess or deficit.

    Protein Imbalances

    • Plasma proteins, especially albumin, are important determinants of plasma volume.
    • Hyperproteinemia is rare and occurs with dehydration-induced hemoconcentration.
    • Hypoproteinemia can occur due to various causes, including anorexia, malnutrition, starvation, fad dieting, poorly balanced vegetarian diets, poor absorption, inflammation, and hemorrhage.

    Hypoproteinemia Clinical Manifestations

    • Edema due to insufficient oncotic pressure.
    • Slow healing, anorexia, fatigue, anemia, muscle loss, and ascites.
    • Management involves a high-carbohydrate, high-protein diet, dietary protein supplements, and enteral or total parenteral nutrition.

    Extracellular Fluid Volume Imbalances

    • Hypovolemia can occur due to loss of normal body fluids, decreased intake, or plasma-to-interstitial fluid shift.
    • Hypervolemia can occur due to excessive intake, abnormal retention of fluids, or interstitial-to-plasma fluid shift.
    • Management involves fluid replacement, diuretics, and fluid restriction.

    Nursing Diagnoses and Implementation

    • Nursing diagnoses for hypervolemia include excess fluid volume, ineffective airway clearance, risk for impaired skin integrity, and disturbed body image.
    • Nursing diagnoses for hypovolemia include fluid volume deficit, decreased cardiac output, and risk for impaired skin integrity.
    • Nursing implementation involves monitoring intake and output, cardiovascular status, respiratory status, neurological function, and daily weights, as well as assessing skin turgor and edema.

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